Mindfulness-based Cognitive Therapy for the Chronic Pain-depression Co-morbidity Among Older Black Adults in the Community; The Quiet Focus Open Pilot
The goal of this clinical trial is to pilot an adaptation of mindfulness-based cognitive therapy for chronic pain and depression. The main questions it aims to answer in a later fully powered randomized controlled trial are:
- Is an adaptation of mindfulness-based cognitive therapy for older Black adults able to improve quality of life?
- Will an adapted mindfulness based cognitive therapy reduce pain interference to a greater degree than a traditional health enhancement program?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Participant Inclusion Criteria
- Older adult (age ≥ 50)
- All individuals who identify with one or more nationalities or ethnic groups originating in any of the Black racial groups of Africa
- Pain in muscles, joints, bones, or associated soft tissues (NRS>4) lasting longer than 3 months
- Depressed (PHQ-9 score of 5-14)
- English fluency/literacy
- Ability and willingness to participate via in-person and video
- No change to type or dose of antidepressant medications for at least 6 weeks prior to screening
- Willing to provide informed consent and comply with all aspects of the protocol
Participant Exclusion Criteria
- Moderately severe or severe depressive symptoms (PHQ-9 ≥ 15)
- Current substance abuse/dependence
- Significant cognitive impairment
- History of more than 8 sessions of cognitive-behavioral therapy
- History of previous training in mindfulness or undergoing counseling more than once a month
- History of or current diagnosis of psychosis
- Active suicidal ideation (PHQ-9 item #9 or otherwise reported during screening) or self-harm within the past 90 days
- Current participation in another behavioral clinical trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Quiet Focus
|
Mindfulness-based cognitive therapy adapted for older adults at-risk for chronic pain and depression.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Credibility and Expectancy Questionnaire
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
This scale measures participant expectations around the study's positive outcomes, with measures ranging from 0 (not at all expected) to 9 (extremely expected).
A higher score indicate greater trust in the study design and an openness to potential benefits.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Modified Patient Global Impression of Change
Time Frame: At end of 8 week program (post test) and again at 3 month follow up visit.
|
Measures participant impressions of overall change with one being very much improved and eight being very much worse.
Lower scores indicate improvement.
|
At end of 8 week program (post test) and again at 3 month follow up visit.
|
|
The Client Satisfaction Questionnaire
Time Frame: Administered at the end of treatment at 8 weeks and at the three month follow up visit.
|
Three item scale measuring patient satisfaction with the program.
Scores for each item range from 1 (unsatisfied) to 4 (very satisfied).
|
Administered at the end of treatment at 8 weeks and at the three month follow up visit.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
PROMIS Depression
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The PROMIS Depression raw score is calculated by summing item responses, each rated on a 5-point Likert scale where 1 = "Never" and 5 = "Always," with higher scores indicating more severe depressive symptoms.
This raw score is converted to a T-score using a standardized table, where 50 represents the average level in the general population and 10 is the standard deviation.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
PROMIS Anxiety
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The PROMIS Anxiety raw score is calculated by summing item responses, each rated on a 5-point Likert scale where 1 = "Never" and 5 = "Always," with higher scores reflecting greater anxiety symptoms.
The raw score is then converted to a T-score using a standardized scoring table, with 50 representing the population average and 10 as the standard deviation.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Measure of Current Status Part A
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The Measure of Current Status Part A (MOCS-A) is a self-report questionnaire that measures ability to manage stress.
The score is calculated by summing responses to each item, rated on a 5-point Likert scale where 0 = "I cannot do this at all" and 4 = "I can do this extremely well," with higher scores reflecting greater confidence in coping skills.
The scale measures current perceived ability to manage stress across areas like relaxation, awareness of tension, assertiveness, and coping confidence.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Chronic Pain Acceptance Questionnaire
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The Chronic Pain Acceptance Questionnaire (CPAQ)*= raw score is calculated by summing responses to each item, rated on a 7-point Likert scale where 0 = "Never true" and 6 = "Always true," with higher scores indicating greater acceptance of chronic pain.
The scale assesses two key areas: pain willingness(the ability to experience pain without trying to control or avoid it) and activity engagement (continuing meaningful activities despite pain).
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Pain Self-Efficacy Questionnaire
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The Pain Self-Efficacy Questionnaire (PSEQ) measures confidence in engaging in activities despite chronic pain.
Higher scores indicate greater confidence (6 = complete confidence) and lower scores indicate lower confidence (0 = not at all confident).
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Pain Catastrophizing Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The Pain Catastrophizing Scale (PCS) score is calculated by summing responses to each item, rated on a 5-point Likert scale where 0 = "Not at all" and 4 = "All the time," with higher scores indicating greater levels of catastrophic thinking related to pain.
The scale measures three components of pain catastrophizing: rumination, magnification, and helplessness.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Tampa Kinesiophobia Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The Tampa Kinesiophobia Scale (TKS) measures fear of movement and is calculated by summing responses to each item, rated on a 4-point Likert scale where 1 = "Strongly disagree" and 4 = "Strongly agree," with higher scores indicating greater fear of movement or reinjury due to physical activity.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
Numerical Rating Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
|
Numerical rating of pain with lower scores indicating less pain overall (0 = no pain) and higher scores indicating more pain (10 = worst ever pain) over the past week.
|
From enrollment to 3 months from the end of treatment at 8 weeks.
|
|
PROMIS Physical Function
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
The PROMIS Depression raw score is calculated by summing item responses, each rated on a 5-point Likert scale where 1 = "Never" and 5 = "Always," with higher scores indicating more severe depressive symptoms.
This raw score is converted to a T-score using a standardized table, where 50 represents the average level in the general population and 10 is the standard deviation.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
|
PROMIS Emotional Support
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
|
The PROMIS Emotional Support raw score is calculated by summing item responses, each rated on a 5-point Likert scale where 1 = "Never" and 5 = "Always," with higher scores indicating greater perceived emotional support.
This raw score is converted to a T-score using a standardized table, where 50 represents the average for the general population and 10 is the standard deviation.
|
From enrollment to 3 months from the end of treatment at 8 weeks.
|
|
Cognitive and Affective Mindfulness Scale-Revised
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
|
Description: The Cognitive and Affective Mindfulness Scale - Revised (CAMS-R) measures percieved ability to complete mindfulness tasks such as meditation, with a 0 being rarely/not at all and a 3 being almost always.
Higher scores indicate greater ability to practice mindfulness skills.
|
From enrollment to 3 months from the end of treatment at 8 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Tony V Pham, MD, MScGH, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2024P001995
- K23AT012363 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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